Predictive value of breath-holding pressure response as a new diagnostic test for latent arterial hypertension detection

Abstract

Background. Latent arterial hypertension (LAH) is a serious health problem and is often underdiagnosed in routine examination. Thus, a sensitive and economical test to detect latent hypertension is needed. Objective. To assess the opportunity of pressure response to voluntary breath holding (30 second breath holding test) to detect masked arterial hypertension in young subjects. Design and methods. 269 young subjects (18-36 years old) with no clinical signs of cardiovascular disease, diabetes mellitus, any chronic diseases including pulmonary diseases, who did not do sports professionally, underwent 30 second breath holding test. Results. The results of breath holding and 24 hour monitoring tests coincided in 250 out of 269 cases (93 %). Latent hypertensions was diagnosed (by 24 hour blood pressure monitoring) in none of the subjects with normal or high normal resting blood pressure and negative breath holding test (negative predictive value - 100 %). For subjects with normal or high normal resting blood pressure, a positive breath holding test (53 subjects) detected latent arterial hypertension in 34 subjects (positive predictive value - 64 %). Conclusions. The breath holding test helps to effectively exclude latent arterial hypertension in healthy subjects and accurately identifies subjects who should be further tested for arterial hypertension.